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Tam NT, Makram AM, Elsheikh R, Khader SAE, Mai AN, Toan NS, Huy NT, Hanh BTM. Assessing the accuracy of the International Academy of Cytology Yokohama System for reporting breast fine needle aspiration biopsy cytology at a Vietnamese oncology centre. Cytopathology 2023; 34:325-333. [PMID: 36988122 DOI: 10.1111/cyt.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/16/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Fine needle aspiration biopsy (FNAB), accompanied by classification systems for cytology, can offer a cheap and convenient option for the diagnosis of breast cancer in women with suspicious breast lumps. In this study, we aimed to assess the accuracy of the International Academy of Cytology (IAC) Yokohama system in a Vietnamese oncology centre. METHODS A retrospective cross-sectional study was conducted from November 2021 to April 2022 at Vietnam National Cancer Hospital. We included patients with full hospital records regarding breast lesions for which FNAB was indicated. A total of 803 patients' FNAB specimens were assessed according to the IAC Yokohama system. The basic characteristics were summarised using the appropriate summary measurements. The risk of malignancy (ROM) was calculated for each classification category. RESULTS The median age was 42.7 years (range: 14-85). The mean size of the lesions was 17.9 mm (range: 4-123 mm). We had 215 histopathological reports. The most common benign and malignant diagnoses were fibroadenoma and invasive carcinoma, respectively. The ROM for categories II, III, IV, and V was calculated as 3.4%, 37.5%, 95%, and 99.2% respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.4%, 97.2%, 98.5%, and 93.2%, respectively. CONCLUSION The IAC Yokohama system offers a good option with which to predict underlying breast pathology using a simple and cheap procedure. However, pathologists require continuous training to ensure accurate interpretation of the slides.
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Affiliation(s)
- Nguyen Thi Tam
- Department of Pathology, Hanoi Medical University, Hanoi, Vietnam
- Department of Pathology, Hospital 199, Da Nang, Vietnam
| | - Abdelrahman M Makram
- School of Public Health, Imperial College London, London, UK
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan
| | - Randa Elsheikh
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan
- Deanery of Biomedical Sciences at Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
- Faculty of Medicine, October 6 University, Giza, Egypt
| | - Sarah Abd Elaziz Khader
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Anh Nam Mai
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan
- Faculty of Medicine, College of Medicine and Pharmacy, Duy Tan University, Da Nang, Vietnam
- Institute for Research and Training in Medicine, Biology and Pharmacy, Duy Tan University, Da Nang, Vietnam
| | - Nguyen-Sy Toan
- Faculty of Chemical Technology and Environment, University of Technology and Education, The University of Da Nang, Da Nang, Vietnam
| | - Nguyen Tien Huy
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan
- School of Global Humanities and Social Sciences, Nagasaki University, Nagasaki, Japan
| | - Bui Thi My Hanh
- Department of Pathology, Hanoi Medical University, Hanoi, Vietnam
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Nikas IP, Vey JA, Proctor T, AlRawashdeh MM, Ishak A, Ko HM, Ryu HS. The Use of the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy. Am J Clin Pathol 2022; 159:138-145. [PMID: 36370120 PMCID: PMC9891409 DOI: 10.1093/ajcp/aqac132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To perform the first meta-analysis regarding the pooled risk of malignancy (ROM) of each category of the Yokohama system for reporting breast fine-needle aspiration, as well as assess the latter's diagnostic accuracy using this new system. METHODS Two databases were searched, followed by data extraction, study quality assessment, and statistical analysis. RESULTS The "Insufficient," "Benign," "Atypical," "Suspicious," and "Malignant" Yokohama system categories were associated with a pooled ROM of 17% (95% CI, 10%-28%), 1% (95% CI, 1%-3%), 20% (95% CI, 17%-23%), 86% (95% CI, 79%-92%), and 100% (95% CI, 99%-100%), respectively. When both "Suspicious" and "Malignant" interpretations were regarded as cytologically positive, sensitivity (SN) was 91% (95% CI, 87.6%-93.5%) and false-positive rate (FPR) was 2.33% (95% CI, 1.30-4.14%). A summary receiver operating characteristic curve was constructed and the pooled area under the curve was 97.3%, while the pooled diagnostic odds ratio was 564 (95% CI, 264-1,206), indicating a high level of diagnostic accuracy. When only "Malignant" interpretations were regarded as cytologically positive, the pooled FPR was lower (0.75%; 95% CI, .39%-1.42%) but at the expense of SN (76.61%; 95% CI, 70.05%-82.10%). CONCLUSIONS Despite Yokohama's system early success, more data would be needed to unravel the system's value in clinical practice.
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Affiliation(s)
| | - Johannes A Vey
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Tanja Proctor
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | | | - Angela Ishak
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Hyang Mi Ko
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Han Suk Ryu
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea,Department of Pathology, Seoul National University Hospital, Seoul, Korea
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3
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Nigam JS, Kumar T, Bharti S, Surabhi, Sinha R, Bhadani PP. The International Academy of Cytology standardized reporting of breast fine-needle aspiration biopsy cytology: A 2 year's retrospective study with application of categories and their assessment for risk of malignancy. Cytojournal 2021; 18:27. [PMID: 34876918 PMCID: PMC8645495 DOI: 10.25259/cytojournal_43_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 06/07/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Breast cancer is the most common cancer in women worldwide. The fine-needle aspiration biopsy (FNAB) may be used as the first-line pathological investigation for evaluation and early diagnosis of the breast lesion. The FNAB helps to differentiate malignant from benign lesions. In the present study, we categorized the breast FNAB cases according to the International Academy of Cytology Yokohama System (IACYS) for reporting breast FNAB cytology and to assess the risk of malignancy (ROM) for each category. Material and Methods A retrospective data of breast lesions were retrieved from the archives of pathology department between January 2018 and December 2019. The study got approval from the Institutional Ethics Committee. Only 123 cases with cytology and histopathological correlation were included in this study. The cytological category was given according to IACYS for reporting breast FNAB cytology. Results The FNAB results were include as insufficient material 3.25% (4/123), benign 46.34% (57/123), atypical 12.2% (15/123), suspicious for malignancy (SM) 4.88% (6/123), and malignant 33.33% (41/123). The ROM was 50%, 7.27%, 40.0%, 83.33%, and 97.5% for NS, benign, atypical, SM, and malignant, respectively. Conclusion FNAB is an important tool in the diagnosis and management of breast lesions, especially in financial constrained developing countries like India with limited resources, where practice of core needle biopsy is limited. The 5-tier IACYS for reporting breast FNAB improves the reproducibility of cytology reports across the world and helps in triaging the breast lesion patients.
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Affiliation(s)
- Jitendra Singh Nigam
- Department of Pathology / Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Tarun Kumar
- Department of Pathology / Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shreekant Bharti
- Department of Pathology / Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Surabhi
- Department of Pathology / Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Ruchi Sinha
- Department of Pathology / Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Punam Prasad Bhadani
- Department of Pathology / Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
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Sarangi S, Rao M, Elhence PA, Nalwa A, Bharti JN, Khera S, Vedant D, Vishwajeet V, Vishnoi JR, Sharma N, Pareek P. Risk Stratification of Breast Fine-Needle Aspiration Biopsy Specimens Performed without Radiologic Guidance by Application of the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Cytopathology. Acta Cytol 2021; 65:483-493. [PMID: 34535580 DOI: 10.1159/000518790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 07/28/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE The International Academy of Cytology (IAC) Yokohama system for reporting breast fine-needle aspiration biopsy (FNAB) cytopathology has been proposed to standardize breast FNAB reporting. The aim of this study was to categorize breast FNAB cases performed by palpation without radiological guidance according to the IAC system, establish the risk of malignancy (ROM) for the categories and assess the system's utility, pitfalls, and implications in low-resource/financial constraint settings. METHODS A retrospective analysis of palpation-guided FNAB of breast lesions performed without radiological guidance between January 2016 and December 2019 was carried out and was correlated with follow-up biopsies wherever available. A total of 1,089 cases were recategorized using the IAC Yokohama system. Histopathology follow-up was available for 400 cases. The data were analysed for ROM, positive predictive value (PPV), and negative predictive value (NPV). RESULTS AND DISCUSSION Out of 1,089 cases, 4.3% (n = 47) cases were categorized as insufficient, 82% (n = 893) as benign, 2.8% (n = 31) as atypical, 2.7% (n = 29) as suspicious of malignancy, and 8.2% (n = 89) as malignant. Some 400 cases had a follow-up biopsy, based on which, the ROM for the categories were 33.3%, 0.4%, 37.5%, 96%, and 100%. The NPV for the benign category was 99.6%. The PPV of the malignant category was 100%, that of combined suspicious of malignancy and malignant categories was 99%, and of combined atypical, suspicious of malignancy, and malignant was 90.6%. CONCLUSION The IAC Yokohama system is useful in standardizing the reporting of cytopathology of breast lesions. FNAB with radiological guidance is ideal but in cases of finance/resource constraints, FNAB by palpation alone is satisfactory if the test result is in the benign, suspicious of malignancy, or malignant categories, which constitute 91.5% of the cases in this study. A repeat ultrasound-guided FNAB and/or core needle biopsy should be recommended for cases in the insufficient/inadequate or atypical categories.
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Affiliation(s)
- Sujata Sarangi
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Meenakshi Rao
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Poonam Abhay Elhence
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Aasma Nalwa
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Jyotsna N Bharti
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Sudeep Khera
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Deepak Vedant
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Vikarn Vishwajeet
- Department of Pathology and Laboratory medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Jeewan Ram Vishnoi
- Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Naveen Sharma
- Department of General Surgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Puneet Pareek
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
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Dixit N, Trivedi S, Bansal VK. A retrospective analysis of 512 cases of breast fine needle aspiration cytology utilizing the recently proposed IAC Yokohama system for reporting breast cytopathology. Diagn Cytopathol 2021; 49:1022-1031. [PMID: 34133084 DOI: 10.1002/dc.24808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/14/2021] [Accepted: 05/19/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Recently the International Academy of Cytology (IAC) introduced a new reporting system for breast fine-needle aspiration cytology that classifies cytologic diagnoses into five-categories: (I) insufficient material, (II) benign, (III) atypical, (IV) suspicious of malignancy, and (V) malignant. The current study was undertaken to categorize the breast lesions utilizing the newly proposed IAC Yokohama classification system and evaluate the risk of malignancy (ROM) for respective categories and the diagnostic yield of this technique. METHODS All FNAs of breast lesions over 2.5 years were categorized retrospectively using the newly proposed IAC Yokohama reporting system. The ROM was calculated along with sensitivity, specificity, positive and negative predictive value, diagnostic accuracy, false positive, and false-negative rate using the histological diagnosis as the gold standard. RESULTS The 512 cases were distributed as follows: Category I (insufficient material) 7.4%, Category II (benign) 74%, Category III (atypical) 5.7%, Category IV(suspicious) 1.4%, and Category V (malignant) 11.5%. Histopathological correlation was available in 285 (55.7%) cases. The respective ROM calculated was 33.3%, 0.5%, 13.3%, 83.3%, and 100% for Category I-V. The Sensitivity, Specificity, Positive and Negative Predictive Value, and Diagnostic accuracy were 95%, 99.5%, 98.27%, 98.6, and 98.5% respectively. CONCLUSIONS Despite previous attempts to establish a standardized diagnostic terminology, there has been a lack of a single internationally approved standardized reporting system allowing substantial diagnostic clarity and incorporating distinct diagnostic categories, each linked with a specific ROM and recommended management. This System also provides enhanced communication between pathologists and attending clinicians for the benefit of the patient.
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Affiliation(s)
- Nutan Dixit
- Department of Pathology, Indira Gandhi ESI Hospital, Delhi, India
| | - Shalini Trivedi
- Department of Pathology, Indira Gandhi ESI Hospital, Delhi, India
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Wong YP, Vincent James EP, Mohammad Azhar MAA, Krishnamoorthy Y, Zainudin NA, Zamara F, Tan GC, Shah SA, Md Isa N, Baharoom A. Implementation of the International Academy of Cytology Yokohama standardized reporting for breast cytopathology: An 8-year retrospective study. Diagn Cytopathol 2021; 49:718-726. [PMID: 33629823 DOI: 10.1002/dc.24731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/01/2021] [Accepted: 02/11/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The International Academy of Cytology (IAC) Yokohama reporting system was recently proposed to serve as a standardized diagnostic platform for the cytological interpretation of breast fine needle aspiration biopsy (FNAB). Five cytological categories were suggested, linked to a certain risk of malignancy (ROM). The aim of this study was to assess the potency of this newly proposed reporting guideline, with a review of literatures. METHODS This is a retrospective study over 8-year duration in which all the breast FNABs performed in our institution were recategorized in accordance to the IAC Yokohama reporting system. Kappa coefficient was used to evaluate the agreement between the proposed cytological category and corresponding histological diagnosis, with the level of significance set at 5%. Cyto-histopathological correlation and its diagnostic performance were also assessed. RESULTS A total of 1136 breast FNABs were analyzed, including 31 repeat FNABs. Of these, 521 (47.1%) cases had matched histopathological results. Respective ROM for each category was: "insufficient" 13.6%, "benign" 0.4%, "atypical" 25.0%, "suspicious" 85.7%, and "malignant" 100%. There was substantial agreement (κ=0.757) between cytology and histopathological results. Our data revealed a high-diagnostic specificity, sensitivity, positive and negative predictive value of 99.3% (95% CI: 97.6%-99.9%), 94.2% (95% CI: 87.9%-97.9%), 98.0% (95% CI: 92.5%-99.5%), 98.0% (95% CI: 96.1%-99.1%) respectively when both the "suspicious" and "malignant" cases were considered as positive tests, with area under the curve of 0.993. CONCLUSIONS The IAC Yokohama system is a reliable, evidence-based, and standardized reporting system that helps to facilitate communication among cytopathologists, radiologists, and surgeons toward individualized patient management.
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Affiliation(s)
- Yin Ping Wong
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Yogeswaran Krishnamoorthy
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Aqilah Zainudin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Farhah Zamara
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Geok Chin Tan
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shamsul Azhar Shah
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurismah Md Isa
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Asmazila Baharoom
- Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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7
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Field AS, Raymond WA, Schmitt F. The International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology: Recent research findings and the future. Cancer Cytopathol 2021; 129:847-851. [PMID: 34029451 DOI: 10.1002/cncy.22450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Andrew S Field
- St Vincent's Hospital Medical School, University of New South Wales, Sydney, New South Wales, Australia.,Medical School, Notre Dame University, Sydney, New South Wales, Australia.,Department of Anatomical Pathology, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Wendy A Raymond
- Department of Surgical Pathology, Flinders Medical Centre/Flinders University, Adelaide, South Australia, Australia.,Clinpath Laboratories, Adelaide, South Australia, Australia
| | - Fernando Schmitt
- Medical Faculty of Porto University, Porto, Portugal.,Institute of Molecular Pathology and Immunology of Porto University, Porto, Portugal.,Health Research Network, Porto, Portugal
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Nicosia L, Bozzini AC, Latronico A, Addante F, Mastropasqua MG, Meneghetti L, Mauri G, De Fiori E, Montesano M, Di Tonno C, Midolo De Luca V, Casadio C, Cassano E. COVID-19 and breast fine needle aspiration cytology method: What should we change? Cytopathology 2021; 32:312-317. [PMID: 33606300 PMCID: PMC8014188 DOI: 10.1111/cyt.12959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/28/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Air-dried slide preparation for fine needle aspiration cytology procedures is currently considered unsafe because of the risk of infectious aerosols of coronavirus 19. This study compares the safety and accuracy of two different protocols, one with and one without air-dried slides. METHODS Starting from 3 March 2020, we discontinued the use of air-dried slides during breast fine needle aspiration procedures. We selected cases collected during two periods: 2 months before and 2 months after 3 March. In both groups, the number of procedures was recorded together with the distribution of the diagnostic categories and the concordance between cytological and histological results on surgical specimens for lesions suggestive of malignancy, using the chi-squared test. RESULTS Of the 100 procedures performed during the pre-COVID-19 period, 55% were negative (C2), 3% were non-diagnostic (C1) and 40% were positive (C4 or C5). Of the 75 procedures obtained during the COVID-19 period, 44% were negative (C2), 2.7% were non-diagnostic (C1) and 52% were positive (C4 or C5). Despite the use of a new protocol during the COVID-19 period, we observed concordance between cytological and histological results for lesions suggestive of malignancy. There was no statistically significant difference concerning the distribution of the diagnostic categories in the two groups. CONCLUSIONS Taking into account the slightly lower number of procedures being analysed during the COVID-19 period, the introduction of a new protocol that does not include air-dried slides is safe and reliable.
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Affiliation(s)
- Luca Nicosia
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Anna Carla Bozzini
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Antuono Latronico
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesca Addante
- Department of Emergency and Organ Transplants, School of Medicine, Section of Anatomic Pathology, University of Bari "Aldo Moro", Bari, Italy
| | - Mauro Giuseppe Mastropasqua
- Department of Emergency and Organ Transplants, School of Medicine, Section of Anatomic Pathology, University of Bari "Aldo Moro", Bari, Italy
| | - Lorenza Meneghetti
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giovanni Mauri
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elvio De Fiori
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Montesano
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Clementina Di Tonno
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Midolo De Luca
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Casadio
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Enrico Cassano
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Sharif A, Tabassum T, Riaz M, Akram M, Munir N. Cytomorphological patterns of palpable breast lesions diagnosed on fine needle aspiration cytology in females. EUR J INFLAMM 2020. [DOI: 10.1177/2058739220946140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Breast cancer is the most common malignant tumor and is a leading cause of death worldwide. This study was planned to find out the frequencies of various types of lesions from palpable breasts of female patients through fine needle aspiration cytology. This retrospective study was carried out during December 2017 to May 2018 on 100 female patients presenting with palpable breast mass at University Medical Complex & Research Center, Sargodha, Pakistan. Following written informed consent from patients, a detailed history, patient age, and clinical examination were recorded. The fine needle aspiration cytology was performed and aspirates were processed following the standard methods for cytopathological examination. The cases were grouped according to the five tier reporting format for breast lesion (C1–C5) laid down by the International Academy of Cytologists (IAC) in 2016. The spectrum of breast lesions on cytomorphological interpretation was 54% benign (C2), 2% atypia/suspicious probably benign (C3), 3% suspicious probably malignant (C4) and 41% malignant (C5). Inadequate/insufficient material (C1) was not included in the study. In this study, the specificity, sensitivity, negative and positive predictive value, and diagnostic accuracy of fine needle aspiration cytology were 100%, 91.11%, 98.18%, 100%, and 98.96%, respectively. In benign lesions, maximum cases were of fibroadenoma (24%) followed by fibrocystic disease (4%), lipoma (3%) while benign phyllodes tumor and galactocele were only 1% each. Breast mass was the chief presenting complaint. Breast cancer was commonest among all the morphological patterns of breast lesions followed by fibroadenoma. This study supports that cytological examination using fine needle aspiration cytology is an economical, rapid, easy and valuable diagnostic tool.
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Affiliation(s)
- Aamir Sharif
- Department of Pathology, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Tahira Tabassum
- Department of Pathology, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Muhammad Riaz
- Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Directorate of Medical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Naveed Munir
- Department of Biochemistry, Government College University Faisalabad, Faisalabad, Pakistan
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